Should doctors feel threatened by nurses?

Doctors don't like nurses prescribing drugs, even in a limited way. The rise of in-store health clinics has pushed this fight to another level

Louise Fletcher as Nurse Ratched, “Big Nurse” in One Flew over the Cuckoo’s NEstThere is always a bit of tension between doctors and nurses. (Want tension? Try this Academy Award winner from 1975.)

These days there's also a growing competition in a new area, the billing relationship.

Living in Georgia I have been treated to annual legislative battles between lobbies for doctors and nurses, with the latter seeking more power and the former trying to deny it to them.

The fight has been especially fierce when it comes to prescriptive power. Doctors don't like nurses prescribing drugs, even in a limited way.

The rise of in-store health clinics has pushed this fight to another level, since the 2006 acquisition of MinuteClinic by CVS/Caremark and Wal-Mart's entry into the space.  

The New England Journal of Medicine voiced many concerns about them last year. They're called "cream-skimming," they put the onus on patients to determine how sick they are, they don't assure continuity of care, and they could just take over.

You can feel the tension whenever these clinics enter a new market. Here it is in California and in Massachusetts.

Partly due to these new opportunities, nursing schools are upgrading their curricula, turning specialty nursing programs into doctoral programs.  

The American Association of Colleges of Nursing calls them doctor of nursing practice degrees. 

So, should doctors, especially internists (formerly called general practitioners) feel threatened? Do you?

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